Doxil (Doxorubicin,
Adriamycin ®, Rubex
®)

Warning
: One of the primary concerns with this medication is if you have an allergy to the substances in it. Before you
receive treatment of this drug, you should tell your doctor whether you have ever had an allergic reaction to this
medicine or its ingredients.

Doxil is a very a potent anti-cancer drug that should be taken with precaution and only if appropriate. In many
cases it should not be taken before discussing all of your medical conditions and other types of drugs with your
doctor. Other drugs, especially anthracycline-types, can cause side effects and other undesirable results when used
at the same time. Also some medical conditions, such as kidney problems, immune system problems, radiation
treatments, infections, liver issues, and heart issues can help your doctor decide whether you should take this
drug.

This medication can augment the effects of infections, increase bleeding and cause you to bruise more easily. You
should try to decrease your risk of getting bruised or cut, and especially washing your hands frequently to avoid
infections.

Indications:
Doxil is intended for the treatment of certain kinds of cancer, particularly ovarian and breast cancer, as well as
AIDS-related Kaposi’s sarcoma, and multiple myeloma. It is similar to other chemotherapy drugs because of the way
it works. This medication enters your bloodstream and then gradually slows or even stops the cancer cells from
growing.

Doxil
is mostly used in the treatment of the cancers:

cervical cancer

endometrial cancer

head and neck cancers

Prostate cancer

liver cancer

chronic lymphocytic leukemia

non small cell lung cancer

p
ancreatic cancer

esophageal cancer

retinoblastoma (acommon intraocular cancer of
childhood)

gestational trophoblastic tumor (a rare form of cancer in women that
rises
in the uterus or womb)

carcinoid tumors (rare tumor that tend to arise in the
gastrointestinal tract and in the lungs)

cancer of the thymus (a small organ in your upper chest, under
your breastbone
)

cancer of the adrenal cortex (the outside layer of the adrenal gland)

Ewing’s sarcoma (a type of canceroccurs in the bone or close to the bone,
most often in adolescents

Dosage:
This medication may only be prescribed and administered by a physician or a health care professional. Your
physician will determine whether Doxil is appropriate for you. The medication is given by injecting for about
thirty to sixty minutes or longer. Your dose is also determined by your doctor according to your body size and
mass, your medical conditions, and your individual response to the therapy. If you experience any side effects
during or after treatment, notify your physician as soon as possible.

You should be careful to not let the drug directly touch your skin or your eyes. If this happens you should wash
your skin with soap and water, or flush your eyes with water for fifteen minutes and then notify medical help as
soon as possible. Because this drug is such a potent substance, you should also avoid touching your urine or other
body fluids for five days after receiving this drug. You or your caregiver should wear gloves during this time and
make sure all equipment is disposed of properly.

Overdose:
Overdose enhances the toxic effects of Doxil. Very high doses of Doxil can cause heart problems and severe aplastic anemia (bone marrow does not produce enough
new cells)
in the space of 10 to 14 days. In fact, heart failure can occur even 6 months after an overdose. If you experience
abnormal effects during or after the treatment, report them immediately to your doctor. Treatment of Doxil overdose
includes supportive measures and possibly blood transfusions. You can also be recommended to stay in hospital for a
couple days.

Contraindications: Doxil
is not recommended in patients suffering from heart disease associated with myocardial failure, chronic
liver or kidney disease. Women who are pregnant or breast-feeding should not be treated with
Doxil.

Interactions
: There are several drug interactions that should be avoided when using this medication. Keep a list of all of your
medications and show them to your doctor before beginning Doxil therapy.

Doxil is highly not recommended with cyclophosphamide(also called 6-mercaptopurine, 6-MP or Purinethol)
; it increases the cardiotoxic effects of Doxil and the risk of hemorrhagic cystitis (inflammation and bleeding inside the
bladder
). When Doxil is administered with mercaptopurine, there is an increased risk of liver
problems. It is also
preferable not to associate Doxil with cyclosporin and live attenuated vaccines.

Side
effects
:
Doxil attacks not only cancer cells but healthy cells; this often leads to the development of adverse effects in
most patients. Most common Doxil side effects include:

fatigue

nausea and vomitting.......................................

mouth sores

hair
loss

abdominal pain

difficulty swallowing

eye watering

nail discoloration

skin discoloration/irritation

swelling, pain, redness, or peeling
of skin on the palms and soles of the feet

Low
blood counts

Although
rare, Doxil may trigger secondary leukemias andsevere heart problems in some patients.

Heart problems
: Doxil can damage the heart muscle and lead to:

chest
pain and tightness

abnormal
heart rhythm

Sudden reddening of
the face, neck, or upper chest.

If you
experience these symptoms, see your doctor immediately. Cardiac and haematological (blood and blood-producing
organs) monitoring is necessary during the treatment. In some cases, your doctor can conduct a complete blood
count and electrocardiogram before each injection. Surveillance should be increased in cases of liver problem
and radiotherapy.

In the
majority of women,
Doxilmay cause
temporary absence of menstruation (amenorrhea). For women approaching menopause,
Doxilmay cause
complete absence of menstruation. The drug may also lead to discoloration of urine and formation of blood clot
within a vein (venous thrombosis).